The case involved a 40 year old morbidly obese male who presented after gastric plication with recurrent weight gain and a desire to achieve weight loss. As per the patient's request, we proceeded with conversion to sleeve gastrectomy. After entry into the lesser sac 6 cm proximal to the pylorus, the gastro-colic omentum was dissected off of the greater curvature. All plication sutures were taken down using Maryland dissectors, Endoshears and Ligasure device. A size 60 Endo-GIA stapler with reinforced black load was used to open the plication tunnel. A 40 Fr Bougie was place and the sleeve gastrectomy was performed starting 6 cm proximal to the pylorus using a Endo-GIA stapler with reinforced black loads in succession to the angle of His. Lembert sutures were used to imbricate the staple line with incorporation of the gastro-colic omentum. An intra-operative leak test was performed with methylene blue and Tisseal was used to reinforce the suture line. A 15 Fr Jackson-Pratt drain was placed anterior to the gastric sleeve and the specimen removed. The post-operative upper GI study was performed on post-operative day 1 re-confirming absence of leak. The patient was discharged home without any issue on post-operative day 2 on a clear liquid diet.